MRCP Part 1 practice question from OnExamination: bradycardia, hypotension, and ST elevation
A 56-year-old man presents to the Emergency department with an inferior myocardial infarction. He has a history of smoking and hypertension and is a poor attendee at the GP surgery.
On initial admission he is hypotensive and bradycardic, with clear inferior ST elevation. He is taken to the catheter lab and stented. You are asked to see him a few hours later as he is persistently hypotensive with poor urine output. He has remained pain free since his stenting.
On examination his BP is 90/50 mmHg, his pulse is 69, he has an elevated JVP, but his chest is clear.
Investigations show
Haemoglobin
140 g/L
(135-180)
White cell count
6.6 ×109/L
(4-11)
Platelets
188 ×109/L
(150-400)
Serum sodium
138 mmol/L
(135-146)
Serum potassium
5.3 mmol/L
(3.5-5)
Creatinine
131 μmol/L
(79-118)
Source: Doc2Doc BMJ Cardiology - Category: Cardiology Authors: OnExamination Source Type: forums
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